Individual provider Active NPI

Jeanette Dea Hoover, ARNP

  • Nurse Practitioner
  • Fort Dodge, IA
National Provider Identifier
1205336385
Registry record updated Feb 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
H107973 Issued in IA
Practice address
802 Kenyon Rd Ste Q
Fort Dodge, IA 50501-5740
Phone
(515) 574-8519
Fax
(515) 574-8514
NPI assigned
Feb 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X H107973 IA Primary

Addresses

Primary practice location

802 Kenyon Rd Ste Q
Fort Dodge, IA 50501-5740

Mailing address

802 Kenyon Rd Ste Q
Fort Dodge, IA 50501-5740
Phone (515) 574-8519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180316000077 IA Practitioner - Nurse Practitioner 6204198989 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Olivera Health Group Ia LLC CurrentSince Jan 27, 2024 Accepting new patients
Trinity Regional Medical Center CurrentSince Mar 5, 2018 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

6420 Council St NE
Cedar Rapids, IA 52402
Phone (319) 393-1447

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

802 Kenyon Rd
Ste Q
Fort Dodge, IA 50501
Phone (515) 574-8519

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518652800000",
    "number": "1205336385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 KENYON RD STE Q",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015740",
            "telephone_number": "515-574-8519",
            "fax_number": "515-574-8514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 KENYON RD STE Q",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015740",
            "telephone_number": "515-574-8519",
            "fax_number": "515-574-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOVER",
        "first_name": "JEANETTE",
        "middle_name": "DEA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-15",
        "last_updated": "2018-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "H107973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Dodge, IA

Sources for this page

Verify at the official NPI Registry.